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Pulp changes from rapid maxillary expansion: A systematic review.

Walbert de Andrade Vieira1, Millena Barroso Oliveira2, Leonardo de Souza Machado3

  • 1Department of Restorative Dentistry, Endodontics Division, State University of Campinas - Unicamp, School of Dentistry of Piracicaba, Piracicaba, SP, Brazil.

Orthodontics & Craniofacial Research
|December 7, 2021
PubMed
Summary

Orthopaedic rapid maxillary expansion (ORME) and surgically assisted rapid maxillary expansion (SARME) may cause temporary pulp vitality and sensibility changes. These procedures also carry a risk of reducing pulp chamber dimensions, though evidence certainty is very low.

Keywords:
palatal expansion techniquepulp chamber dimensionspulp sensibilitypulpal blood flowsystematic review

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Area of Science:

  • Dentistry
  • Orthodontics
  • Craniofacial Surgery

Background:

  • Orthopaedic rapid maxillary expansion (ORME) and surgically assisted rapid maxillary expansion (SARME) are common orthodontic procedures.
  • Potential side effects on dental pulp vitality, sensibility, and dimensions require systematic evaluation.

Purpose of the Study:

  • To systematically review existing evidence on pulp changes following ORME and SARME.
  • To assess the impact of these expansion techniques on dental pulp health.

Main Methods:

  • A comprehensive electronic search of eleven databases was conducted.
  • Included studies assessed pulp vitality, sensibility, or chamber dimensions before and after ORME/SARME.
  • Risk of bias and certainty of evidence were evaluated using established tools (NIH, JBI, GRADE).

Main Results:

  • Seven before-after studies were included, examining permanent maxillary teeth.
  • Temporary changes in pulpal blood flow and sensibility were observed post-ORME/SARME.
  • A reduction in pulp chamber dimensions was noted in some studies, with very low certainty of evidence.

Conclusions:

  • Limited evidence suggests ORME and SARME can induce temporary pulp vitality and sensibility alterations.
  • These expansion techniques may lead to a reduction in pulp chamber size.
  • Further high-quality research is needed due to the very low certainty of the current evidence.